Posted on: Saturday, September 7, 2002
PRESCRIPTIONS
Certain fish may pose risks for keiki, pregnant women
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By Dr. Landis Lum
Q. I'm trying to get pregnant, and my doctor told me eating too much of certain fish may be dangerous for both me and my 2-year-old because of high mercury levels. What gives?
A. Yes, it's true — some fish have high levels of mercury that, if eaten regularly, can harm an unborn child's developing brain. At the same time, seafood is a good source of high-quality protein and other nutrients, is low in fat, and can be an important part of a balanced diet for pregnant women.
And not just pregnant women are at risk— young keiki and nursing mothers need to avoid eating too much of certain fish, as too much mercury may affect a child's behavior and lead to learning problems. The worst are shark, swordfish (a'u, ku or shutome) and king mackerel — if you're pregnant or trying to get pregnant, are breastfeeding, or are a young child, don't eat these at all.
Mercury occurs naturally in the environment and is also released into the air through industrial pollution. Mercury falls from the air into streams and oceans, and then gets into fish through their gills, or fish may feed on other aquatic organisms that have themselves absorbed mercury.
Older, larger fish that feed on other fish accumulate the highest levels of mercury. Therefore, women and keiki in the above groups shouldn't eat any large predator fish such as marlin (a'u, kajiki, nairagi) and opah (moonfish) more than once a month. And if they DO eat one of these, they need to wait a month before eating smaller predator fish that may also have mercury, such as 'ahi (tuna), aku, canned tuna, orange roughy, mahi-mahi, onaga, opakapaka (snapper), halibut, cod, kaku (barracuda), pollock and grouper. Furthermore, they shouldn't eat any of these smaller predator fish more often than once a week. No method of cooking or cleaning fish will reduce its mercury content.
The good news is that they can eat as much as they like of the following: salmon, scallops, shrimp, ika (squid or calamari), tako (octopus), and small fish that can fit in a frying pan whole, such as akule, awa (milkfish), butterfish and opelu. In fact, cold-water fatty fish like salmon have omega-3 fatty acids that have been shown to reduce heart disease, so don't stop eating fish altogether. (My favorite is butterfish).
Answer to another reader's query: Yes, it's OK to take a Tylenol 8 hours after taking Celebrex.
Dr. Landis Lum is a family practice physician for Kaiser Permanente and an associate clinical professor at the University of Hawai'i John A. Burns School of Medicine.
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